浅谈创伤弹道学的理论及应用

创伤弹道学是研究投射物(弹丸、破片)击中机体的致伤效应和致伤原理的科学,熟悉创伤弹道学的基础知识,有助于外科医生在处理火器伤时,正确判定投射物的种类,损伤类型和范围,确定切实可行的治疗方案。本文介绍创伤弹道学的基础知识,并结合肌组织投射物伤的典型伤例进行讨论。     

我国创伤弹道学研究的过去,现在和将来

我国创伤弹道学研究的过去、现在和将来王正国我国是一个经历了多次战争的国家，它拥有一支庞大的军队和较为完善的军队医疗卫生系统，所救治的伤员数至少在数十万人以上。仅在三年朝鲜战争中，救治的中国军队伤员数就有３８３２１８名，伤员和阵亡的比例为３．３６：１［...     

致伤因子-能量-创伤在中国第二届全国创伤弹道学会议上的报告

我能被邀请参加这次重要的学术会议并有机会介绍我们肤浅的研究工作深感荣幸。1985年6月在瑞典召开的第五届国际创伤弹道学会议上，中国学者曾作出重大贡献，由此使我深信，在座的诸位都是在这方面有丰富知识的专家。     

第五届全国武器创伤学及创伤弹道学会议论文综述

中华医学会创伤学分会创伤弹道学组和全军战创伤专业委员会武器创伤学组联合举办的第五届全国武器创伤学及创伤弹道学学术会议,于1999年12月6～8日在重庆第三军医大学附属大坪医院野战外科研究所召开。会议共交流论文110篇,并邀请部分专家学者做专题报告。现将会议论文主要内容综述如下。一、专题报告中国工程院院士王正国在会议上做了题为“创伤弹道学研究的思考”的报告,指出未来战争将广泛采用高新技术,空袭和反空袭将成为重要的战争形式,火器伤仍是主要伤类,创伤弹道学研究应向武器创伤学方向扩展,研究各种新型的特殊武器(如激光、微波…     

超高速投射物致伤作用的初步观察

创伤弹道学的研究表明 ,高速投射物的致伤能力取决于其能量、质量及飞行中的稳定性等因素 ,其中速度为最重要的因素[1 ] 。笔者在先前研究的基础上 ,将投射物的初速度提高至 3.0ｋｍ ｓ左右 ,以探讨超高速投射物的致伤作用并进一步研究速度在致伤中的作用。一、材料与方法1.致伤装置为二级气炮 (西北核工业研究所 ) ,钢珠 (外被纤维包膜 )直径1.0ｃｍ ,质量 1.0ｇ。射距 5 .0ｃｍ。靶标为生物靶标 (成年中国家兔 2只 ,雌性 ,第四军医大学实验动物中心提供 )、非生物靶标 (肥皂 2块 ,2 0ｃｍ× 2 0ｃｍ× 30ｃｍ ,按实验要求制作[2 ] )。2 .…     

Historical overview of wound ballistics research

Ballistics involves the study of the scientific properties of projectiles, their behavior and their terminal effects on biological tissues and other materials. Wound ballistics deals with the analysis of injuries caused by projectiles and the behavior of projectiles within human or other biological tissues. The nineteenth century witnessed the development of both of these areas with Kocher’s hydrodynamic theory and the understanding of the significance of bullet deformation in causing tissue injury. The degree of traumatic disruption of tissues and organs was also related to direct energy transfer from projectiles. While subsequent research has concentrated on elucidating further mechanisms of injury, the exact cause of remote tissue damage from high energy projectiles is still the subject of ongoing research. Much of the contemporary literature regarding wound ballistics concentrates on the forensic aspects and their application for legal purposes, in particular the investigation of shooting scenes. There have been many advances in this area, particularly in relation to the identification of various types of gunshot wounds and how their appearance can be used to establish if a shooting was accidental, deliberate (homicidal) or self inflicted (suicidal).     

The use of gelatine in wound ballistics research

Blocks of gelatine are used in both lethality and survivability studies for broadly the same reason, i.e. comparison of ammunition effects using a material that it is assumed represents (some part of) the human body. The gelatine is used to visualise the temporary and permanent wound profiles; elements of which are recognised as providing a reasonable approximation to wounding in humans. One set of researchers aim to improve the lethality of the projectile, and the other to understand the effects of the projectile on the body to improve survivability. Research areas that use gelatine blocks are diverse and include ammunition designers, the medical and forensics communities and designers of ballistic protective equipment (including body armour). This paper aims to provide an overarching review of the use of gelatine for wound ballistics studies; it is not intended to provide an extensive review of wound ballistics as that already exists, e.g. Legal Med 23:21–29, 2016. Key messages are that test variables, projectile type (bullet, fragmentation), impact site on the body and intermediate layers (e.g. clothing, personal protective equipment (PPE)) can affect the resulting wound profiles.

     

Gunshot wounds: Radiology and wound ballistics

Bullets of equal wounding potential may produce wounds of very different severity. Wounding is an interaction between the missile and the tissue. When attempting to predict wound severity, focusing on missile velocity while forgetting either the properties of the tissue wounded or the missile’s mass and construction leads to very poor predictions. Fortunately, all the poor predictions commonly made are of little consequence as it is the condition of the patient, not the type of firearm or missile used, that determines the treatment needed. Tissue crush and tissue stretch by displacement (temporary cavitation) are the only wounding mechanisms of missiles. Tissue stretch is tolerated very differently by different tissues. Missiles can embolize. Missile type, direction of fire, and order of shots can sometimes be assessed radiologically. Lead bullets or fragements in joints cause lead synovitis, mechanical arthritis, and sometimes lead poisoning. When possible, they should be removed. For shotgun wounds, steel shot may be ferromagnetic and is important to recognize prior to magnetic resonance imaging. Steel shot stays round and does not deform like lead shot. The "billiard ball effect" may compromise assessment of range unless correlated with skin physical examination. This article was presented at the Annual Meeting of the American Society of Emergency Radiology, Scottsdale, Arizona, on March 27, 1995.     

Doppler radar velocity measurements for wound ballistics experiments

Bullet velocity is a basic parameter in wound ballistics studies. It is usually measured electronically by means of a variety of solid or photoelectric barriers connected to equipment measuring the time elapsing between impulses, enabling the velocity to be calculated. With the advent of Doppler radar velocity measurement of large calibre artillery shells, the use of this equipment for wound ballistics experiments was investigated. Anaesthetized pigs were shot at a range of 9–10 metres and the velocities measured by Doppler radar and photocells were compared. A very good correspondence between the measured entry and exit velocities in low and medium velocity bullets was found, i.e. an average deviation of less than 1% (range 0–2%) between the two types of equipment. In high velocity bullets measurement of entry velocities was just as good, but in both methods measurement of the exit velocity was complicated by the cluttering of signals by fragments of tissue released from the exit wound and the deflection of the bullet, Doppler radar offers important benefits — simple set up, minimal risk of damage of equipment by stray bullets and very good accuracy — and may replace photocells and similar equipment in studies involving low and medium velocity bullets. Measurement of the exit velocity of high velocity bullets is unsatisfactory in both methods, and it is necessary to improve the Doppler radar method in order to measure that as well.     

Wound ballistics: contemporary and future research

Wound ballistics research has contributed much to the understanding of the pathophysiology of missile injury that now exists. From this store of knowledge treatment regimes have evolved which have greatly improved the lot of the soldier wounded in war. However, research must keep pace with changes that are taking place in weapons research and development so that the particular needs of the Army Medical Services on a future battlefield can be met. The differing needs of civilian and military medical services are highlighted. The marked differences that exist between the missile wound seen and treated in a late twentieth century hospital and the wounds likely to be encountered on the modern battlefield are enumerated and discussed.